Modvation Speaker Application

MoVation Diversity Ventures is a Community Hub for Entrepreneurs, Innovators, Gamechangers, Investors, Artists, Local Distinguished Community Leaders, Media, Press and more, focusing on the convergence of Art and Technology.

It is a conference designed to be a One-Hours talk, split between startup competition, a fireside interview with a celebrity keynote speaker, and a panel dicussion about inspirations worth sharing to empower our growing diverse community in diffent industries.

Primary Speaker's Name

First NameLast Name

What are you Applying for? *

Choose from the list

Company Name as Applicable. If not applicable place a N/A in the box.*

Company Website

City*

State*

Your Industry*

Your Web Site

Phone Number*

Area CodePhone Number

E-mail*

Confirmation Email

The title of your session is the first impression for Conference Attendees. Use a concise, but inclusive, title which clearly conveys what you will be presenting and draws attendees' attention to your topic.

Title of Your Session:*

Industry Category *

Choose from the category

Write a Category Not Listed Above

Abstract: Your session abstract will tell Conference Attendees why they should attend your session. To be effective and create interest, it should provide a brief, clear, and concise reflection of your presentation’s content. The abstract should only be one paragraph of between 150 to 250 words in length.*

Outline Your Key Elements. List 4 to 5 primary or key elements of your topic that you will be discussing.*

Target Audience*

Have you given this presentation before and/or you do you intend to present it elsewhere in the near future?*

If YES, please list where and when - If NO place N/A in the box.*

Please provide references with phone number or email - If NO place N/A in the box.*

Bio for Speaker # 1*

Speakers Name # 2

Are you both an Exhibitor and a Speaker? In order to schedule your session properly, let us know.*

I agree to submit my presentation prior to the Conference *

I understand that my presentation will be available on the Modvation's website for members to download*

I have verified that all information provided is accurate. and complete*

Yes

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